Children, Exercise and Injuries Part 2

In part 1 the human body growth in adolescence was explained and the benefits of exercise for children.

In this concluding part we are going to look at typical injuries that can occur, how they happen and what can be done to help and manage.

Growing Pains:

Children between the ages of 3 to 12 years of old can complain of aches, pains or cramp like sensation in both legs. This type of pain is more common during the evening or at night. “Growth spurts do not play a part in this condition” (Smith, F 2006. p456) In fact growing pains are difficult to actually be proven. Some studies have shown that over use during sport can trigger these aches due to bone fatigue. It has also been suggested that it could be restless leg syndrome rather than growing pains and sometimes this can be hereditary. (smith, F)

Delayed Puberty

I have watched sport for many years, I particularly like running and gymnastics. I remember hearing that for young girls it was quite the norm to not have periods because of the intensity of their workout. I found out this is actually correct.

Delay in growth and maturation is more frequent in gymnasts than swimmers. Gymnasts tend to be shorter than other girls their age. However, growth can also play catch up once they have completely stopped, reduced, or stop training for a while. They seem to have a significant lower percentage of body fat when comparing to other girls the same age. The impact of emotional stress, constant competitions, keeping their weight maintained in a low number and of course the impact of the demands from their coach can all impact growth and their pubertal timing (Rogol)

” The implications of delayed menarche are directly relevant to the accrual of bone mineral. Because >90% of the total adult bone mass is established during the pubertal years. A low rate of bone mineral accrual has been suggested as one factor contributing to skeletal injuries in gymnastics.” (Rogol, A et al, P527s)

Incorrect Nutrition

When exercising Nutrition is one of the key factors to help not only repair muscle but also to give energy. Many kids/adolescence do not know the importance of what they eat and especially how much they eat.

At 13 years of age a boy should consume 2414 kcal daily and a girl 2223 and slowly increases to:

and at 18 years of age a male should consume 3155 kcal daily and a girl 2462 (NHS)

This is obviously just general day to day. This does not include how much they should be eating if they are participating in lots of sports. Not eating enough can be a contributor to lack of growth as well as for females, delayed menarche.

Bose says that there are nine different amino acids essential for growth and anything less will result in stunted growth or other. Vitamins also play a vital role :

Vit C is essential for bone, tissue growth, healing wounds, maintenance of cartilage and any deficiency would mean that the substance of the bone is inadequately formed.

Vit A is thought to be control activities of osteoblasts. (osteoblast are cells that make bone). Lack of these would result in less bone mass meaning it would not be strong or not formed properly.

INJURIES

In part one the Epiphyseal plate was discussed explaining that this area allows the bone to grow. If there is any trauma, for instance a fracture to the site then this can cause permanent damage by either cessation or unevenness to the growth. It has been noted the majority of epiphyseal injuries are during the growth spurt. (Malina).

Osteochondral Injuries:

Most people have heard of Osgood-schlatter’s disease. It’s the one that many cannot pronounce! This particular injury is where the joint surface of the tibia tuberosity (below the knee cap) becomes vulnerable from over uses of sports: jumping, sprinting, football or kneeling. There is inflammation which causes swelling around the area. Pain during sports and also possible referral hip pain.

The below table shows you the many other different types of Osteochondral Injuries, with symptoms as above, pain and swelling.

Name

Where on the body

Layman’s Term

Sinding-Larsen-Johansson Syndrome

Patella (Inferior Insertion)

Above the kneecap

Sever’s Disease

Calcaneus

Ankle

Kohler’s Disease

Navicular

Inside of the foot

Palmer’s Disease

Olecranon

Elbow

Scheuermann’s Disease

Thoracic Spine

Back from Ribs upwards

Keinbock’s Disease

Lunate

Wrist

Freiberg’s Disease

Second Metatarsal head

Top of Foot

Kohler’s II

Third Metatarsal head

Top of Foot

(Gerrard, D 1993 p17)

Other things to think about:

When there is a growth spurt the muscle itself remains taut so therefore loss of flexibility which can also put the stress on the bone also causing apophysitis ( table above)

Its also important to think about the particular sport involved. For example, a swimmer that has a very active training programme can get swimmers shoulder or impingement. “vigorous repetitive hyperextension of the lumbar spine, low back pain may present. Rapid growth of the vertebral bodies is not matched by an increase in the dorsal, tethering soft tissue structures. As a consequence, many young athletes have an increased lumbar lordosis”. (Gerrard, D 1993 p 17) This is just an example for swimming but obviously certain sport affects specific joint more than others.

WHAT CAN YOU DO TO HELP?

Hydrate

Make sure that there are drinking sufficient water. If they do excessive exercise then this amount needs to be increased. You can go to my video on water and see how much they should be drinking.

Nutrition

As mentioned earlier, lots of Vit A, C and D. Recovery: enough protein for muscle repair and carbs to help give them to energy for their sport. Sports drinks are high in sugar, they are good for long endurance sports but it is very easy to make you own without the excess sugar. You don’t have to get calorie specific as explained earlier just think about the sport they are doing, if its a lot they need to eat a bit more. The tip here is to have good healthy food and enough of it to keep the body functioning properly.

Track the exercise

Are they doing too much? Remember that they are excising also at school too. Prioritise what is important to them and keep their exercise to a minimum.

Recovery

Allow time for recovery from what they are doing. In other words no excessive training every day. Are they stretching enough? The answer is most probably not. They need to and also its a great way to set up for life when you get into that routine straight away.

Listen and observe

Sometimes children will not tell you when they have got an injury because they don’t want to stop their sport, they don’t want to let the team down. If you are watching them play a sport and you see them changing their normal posture or limp, address it. If they tell you they have a problem, listen. You know your child more than any one and they know themselves too.

Rest during growth spurt & Injury

We have all seen the film Big with Tom Hanks when he goes to bed as a child and then wakes up as a man! Obviously this is a huge growth spurt! But the thought process is that if you know your child is going through theirs, reduce their exercise straight away. By doing this you are allowing time for the body to adapt and not do any damage. Also if they have picked up a slight niggle during training, rest. Failure to do this straight away will only make the injury longer to recover from.

And the final one

Seek help. If you are unsure about how your child is feeling then get professional advice.

So that’s it!! I hope you enjoyed reading this blog. Please feel free to contact me for any information on treatments etc. Self care is very important in any sport, so regularly monthly treatments with post care advice is always a positive thing to have.

Manlina, I (2014). “Growth development and Maturity in Children and Adolescent: Relation to Sports and Physical Activity. American Journal of Sports Science and Medicine. Vol. 2. no 5A. [online]. Available at: https://www.researchgate.net/publication/267453319_Growth_Development_and_Maturity_in_Children_and_Adolescent_Relation_to_Sports_and_Physical_Activity. (Accessed 12th March 2019)

NHS (2018). “How many calories do teenagers need”. [online]. Available at: https://www.nhs.uk/common-health-questions/childrens-health/how-many-calories-do-teenagers-need/ (Accessed 3rd April 2019)Rogol, A et al. (2000) ” Growth and pubertal development in children and adolescents :effects of diet and physical activity. Research gate. [online]. Available at: https://www.researchgate.net/publication/12399915_Growth_and_pubertal_development_in_children_and_adolescents_Effects_of_diet_and_physical_activity (Accessed 12th March 2019)